It also affirmed the judge's order that the federal sentence be served consecutive to state prison terms of at least 40 years for sexually assaulting several young athletes. They were among scores he molested during a high-profile career that included treating U.S. gymnasts are four Olympic games.

The prison terms are essentially life sentences for the 55-year-old Nassar.

Nassar challenged U.S. District Judge Janet Neff's order that he serve three 20-year sentences consecutively, to be followed by prison terms of at least 40 years, and up to 175 years, later handed down on Eaton and Ingham counties for sexual assault.

Neff said Nassar, who molested children under the guise of providing medical treatment, should never have the chance to be around children again.

"In deciding to impose consecutive sentences, the district court relied on the duration, enormity, and gravity of Nassar's criminal conduct; the serious harm that Nassar inflicted on his victims; and the serious safety threat that Nassar presents to the public," the Sixth Circuit Court of Appeals panel said.

Nassar, once an internationally renowned sports doctor, sexually abused dozens of prepubescent and teen-age girls over the court of two decades. He also amassed a collection of 37,000 images and video of child pornography.

He had paid to have data wiped from a laptop computer's hard drive but failed to get rid of four other hard drives containing child pornography, the panel said.

Neff sentenced Nassar in her Grand Rapids courtroom in December. As part of her ruling, she said that Nassar's then-upcoming state sentences for sexual assault would be served consecutive to the federal term.

Nassar's attorney, Amy Lee Copeland, argued that the state cases did not qualify as a "prior sentence" in computing advisory sentencing guidelines. She said that that consideration of the state cases significantly raised guidelines.

Copeland also argued that the federal and state sentences should run concurrently.

"Judge Aquilina clearly understood the importance of righteous indignation. She also understood the role of the court to have this emotion controlled by the judge rather than allow it to run wild in the community," Garcia wrote.

Nassar's attorneys said that the hearing, which lasted nearly two weeks and was aired on national television, led to Nassar being attacked shortly after he was booked into a federal prison.

Nassar was on the faculty of MSU's College of Osteopathic Medicine from 1997 until he was fired in September 2016 when his crimes were exposed. He also was practitioner at the school's sports-medicine clinic.